Post Traumatic Stress Disorder (PTSD)
PTSD is a debilitating mental condition that affects people who have experienced a traumatic event. PTSD manifests itself through disturbing thoughts and feelings related to the initial trauma. It’s estimated that nearly 3.5% of all adults in the United States have PTSD, with a large number of them being combat veterans.
The current methods to help treat PTSD are trauma-focused therapies and pharmacotherapy. Types of therapies can include exposure therapy, psychotherapy, or cognitive behavioral therapy. For drugs, patients are almost always given selective serotonin reuptake inhibitors (SSRIs) which are the only FDA approved pharmaceuticals approved for PTSD.
The main problem is that many people suffering from PTSD do not have access to effective therapies. To make matters worse, current research has found that using SSRIs do not reduce PTSD symptoms effectively enough.
In light of these problems, alternative solutions have been sought out. One glimmering beacon of hope is the use of cannabis for the treatment of PTSD. However, the politics and federal legality of cannabis has mired the progress of widespread research. As a result, there is not much clinical evidence of a positive influence between cannabis and PTSD just yet.
The good news is that the shifting legal and political stance in the US on cannabis is helping more official research be conducted on its medical uses, especially for treating PTSD.
Can Cannabis Help PTSD Symptoms?
On a physiological level, PTSD is distinguished by amygdala hyperactivity. The amygdala is a set of neurons in the brain which is responsible for processing emotions, so individuals with a hyperactive amygdala can be constantly on edge, and are not able to properly process traumatic memories.
CB1 receptors are endocannabinoid receptors that are triggered by THC, and they’re found abundantly throughout the amygdala. Previous studies have found that the endocannabinoid system can help process emotional memory and reduce fear and anxiety when interacting with certain cannabinoids such as THC.
What Studies Have Been Done?
Studies are being conducted around the globe to prove the benefits of cannabis on PTSD. Each study is unique, but they usually examine the reduction of PTSD symptoms after a period of cannabis usage.
At the moment, there are only a few high-quality articles that have been published and they differ on the types of cannabis administered, such as pure THC, pure CBD, synthetic cannabinoids, and full-spectrum flower or extracts.
In order to quantify PTSD symptoms, most papers use a system known as CAPS, which is the Clinically Administered PTSD Scale. This scale allows researchers to make a diagnosis of PTSD using a numbered scale, so the higher the number the worse the PTSD.
At the end of a study if the CAPS score is lower than the score taken at the start, then it means the cannabis or cannabinoid helped treat symptoms.
In 2014, researchers in Israel administered 5mg of THC sublingually twice a day to 10 patients suffering from chronic PTSD. At the end of the trial, it was found that their CAPS score was significantly lower, with patients having fewer nightmares and better sleep quality overall.
A small case study in 2018 used pure CBD for the treatment of PTSD in 11 patients over a period of 8 weeks. The pure CBD was given in varying amounts and at the end of the study, the participants’ CAPS scores decreased on average by 28%.
A higher number of studies have been published on the effects of whole flower. At a conference in Arizona in 2012, results from a study of whole flower’s effects on PTSD from Israel were presented. The cannabis used was 23% THC and 1% CBD, and they were to smoke daily for about one year.
At the start of the study, the CAPS scores were on average extremely high. After one year of smoking, they dropped by nearly half. Most of the patients started with severe PTSD and ended with moderate PTSD symptoms.
Current PTSD and Cannabis Research
The only problem with these studies is that there are no clinical trials completed yet. Most of the previously mentioned studies are not clinical studies but pre-clinical. The point of them is to show a positive outcome so that there is more motivation or substantial evidence to perform a large, controlled study.
So far there are only a few clinical trials being performed. The only FDA approved study is being conducted by Dr. Sue Sisley at the Scottsdale Research Institute. Dr. Sisley’s study hopes to highlight the medical use of cannabis for treating PTSD. So far, the trials are finished but the data is yet to be analyzed and made publicly available.
One more clinical trial on the effects of cannabis on PTSD is being performed at the University of British Columbia. The trial is still ongoing and is estimated to take until 2022 to be fully completed.
DEA Approval Slows the Process
The reason why many studies on cannabis and PTSD are from other countries and not many are from the United States is due to the stonewalling from the Drug Enforcement Agency. For researchers to perform studies using marijuana, they must get approval from the DEA.
The DEA has actively stalled research, especially in the case of Dr. Sisley. Dr. Sisley worked tirelessly for over 5 years to get approval for her study and ended up suing the DEA for lack of quality source material to dispense to study subjects.
Low-Quality Cannabis for Important Research
As stated, another significant issue is the quality of the cannabis that researchers use. People from states with legal cannabis are used to high-quality, pungent, flowers coated with resin. However, it’s a completely different story for medical researchers.
Dr. Sisley posted a photo of the medical marijuana she received for her study, which looks like almost nothing but pulverized leaves and stems.
The problem is that researchers can only get their cannabis from NIDA (National Institute on Drug Abuse). It’s grown only at one facility, the University of Mississippi, which provides all the cannabis for federal research.
The facility claims that their marijuana has a THC content of 13%, but Dr. Sisley tested it and found a maximum of 8% THC. On top of that, their cannabis was found to have mold and yeast levels that exceed the safe consumption standards in most medical states.
This conundrum is a slap in the face to researchers for two reasons. First, they want to provide clean and safe cannabis to the patients of their study. Second, it makes it difficult to research the impact of actual high-quality cannabis instead of the sub-par cannabis they are being given to work with.
The good news is that the DEA says that they will be expanding marijuana research and that they will allow more growers to produce safe and effective cannabis. Whether or not they keep their word remains to be seen.
The Path to Effective Treatment for PTSD
Thanks to the efforts of researchers like Dr. Sisley, and organizations like MAPS, the research into cannabis and PTSD symptoms continues.
Hopefully, after the favorable outcome of more cannabis studies, people out there with PTSD will be able to get the effective treatment they deserve. Read more about cannabis and its relationship to the VA here.